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information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report.
<br />Refer to the implementing guidance published by the Office of Management and Budget for additional information.
<br />1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of
<br />a covered Federal action
<br />2. Identify the status of the covered Federal action
<br />3. Identify the appropriate classification of this report. If this is a follow -up report caused by a material change to the
<br />information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last
<br />previously submitted report by this reporting entity for this covered Federal action
<br />4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check
<br />the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or sub -award recipient.
<br />Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not
<br />limited to subcontracts, subgrants and contract awards under grants.
<br />5. If the organization filing the report in Item 4 checks "Subawardee ", then enter the full name, address, city, state and zip code
<br />of the prime Federal recipient. Include Congressional District, if known.
<br />6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below
<br />agency name, if known. For example, Department of Transportation, United States Coast Guard.
<br />7. Enter the Federal program name or description for the covered Federal action (Item 1). If known, enter the full Catalog of
<br />Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.
<br />8. Enter the most appropriate Federal Identifying number available for the Federal action identified in Item 1 (e.g., Request for
<br />Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant, or loan award
<br />number, the application1proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP- DE -90- 001."
<br />9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal
<br />amount of the award/loan commitment for the prime entity identified in Item 4 or 5.
<br />10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified
<br />in Item 4 to influence the covered Federal action
<br />(b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a), Enter
<br />Last Name, First Name and Middle Initial (MI).
<br />11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying
<br />entity (Item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that
<br />apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made.
<br />12. Check the appropriate boxes. Check all boxes that apply. If payment is made through an in -kind contribution, specify the
<br />nature and value of the in -kind payment.
<br />13. Check the appropriate boxes. Check all boxes that apply. If other, specify nature.
<br />14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and
<br />the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with
<br />Federal officials. Identify the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s) of
<br />Congress that were contacted.
<br />15. Check whether or not a SF -LLL -A Continuation Sheet(s) is attached.
<br />16. The certifying official shall sign and date the form, print his /her name, title, and telephone number.
<br />Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for
<br />reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing
<br />the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
<br />including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-
<br />0046), Washington, D. C. 20503
<br />Attachment number 4
<br />F -6 Page 105
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